Pretreatment with statins improves early outcome in patients with first-ever ischaemic stroke: a pleiotropic effect of statins or a beneficial effect of hypercholesterolemiaReportar como inadecuado




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BMC Neurology

, 10:47

First Online: 18 June 2010Received: 04 February 2010Accepted: 18 June 2010

Abstract

BackgroundData from different studies suggest a favourable association between pretreatment with statins or hypercholesterolemia and outcome after ischaemic stroke. We examined whether there were differences in in-hospital mortality according to the presence or absence of statin therapy in a large population of first-ever ischaemic stroke patients and assessed the influence of statins upon early death and spontaneous neurological recovery.

MethodsIn 2,082 consecutive patients with first-ever ischaemic stroke collected from a prospective hospital-based stroke registry during a period of 19 years 1986-2004, statin use or hypercholesterolemia before stroke was documented in 381 patients. On the other hand, favourable outcome defined as grades 0-2 in the modified Rankin scale was recorded in 382 patients.

ResultsEarly outcome was better in the presence of statin therapy or hypercholesterolemia cholesterol levels were not measured with significant differences between the groups with and without pretreatment with statins in in-hospital mortality 6% vs 13.3%, P = 0.001 and symptom-free 22% vs 17.5%, P = 0.025 and severe functional limitation 6.6% vs 11.5%, P = 0.002 at hospital discharge, as well as lower rates of infectious respiratory complications during hospitalization. In the logistic regression model, statin therapy was the only variable inversely associated with in-hospital death odds ratio 0.57 and directly associated with favourable outcome odds ratio 1.32.

ConclusionsUse of statins or hypercholesterolemia before first-ever ischaemic stroke was associated with better early outcome with a reduced mortality during hospitalization and neurological disability at hospital discharge. However, statin therapy may increase the risk of intracerebral haemorrhage, particularly in the setting of thrombolysis.

List of abbreviationsANOVAAnalysis of variance

CIConfidence interval

COPDChronic obstructive pulmonary disease

CTComputed tomography

MMPMatrix metalloproteinase

MRIMagnetic resonance imaging

mRSModified Rankin scale

OROdds ratio

SDstandard deviation.

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Autor: Adrià Arboix - Luis García-Eroles - Montserrat Oliveres - Cecília Targa - Miquel Balcells - Joan Massons

Fuente: https://link.springer.com/







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